Bloodborne Pathogen Standard

HIV and the hepatitis B virus (HBV) are major health concerns. The health team is at risk for exposure to the viruses. The Bloodborne Pathogen Standard is intended to protect them from exposure. It is a regulation of the Occupational Safety and Health Administration (OSHA).

HIV and HBV are found in blood. They are blood-borne pathogens. They exit the body through blood.

 They are spread to others by blood. Other potentially infectious materials (OPIM) also spread the viruses.

BLOODBORNE PATHOGEN STANDARD DEFINITIONS

·       Blood. Human blood, human blood components, and products made from human blood

·       Bloodborne pathogens. Pathogens present in human blood and that can cause disease in humans; they include but are not limited to hepatitis B virus (HBV) and human immunodeficiency virus (HIV)

·       Contaminated. The presence or reasonably anticipated presence of blood or other potentially infectious materials on an item or surface

·       Contaminated laundry. Laundry soiled with blood or other potentially infectious materials or that may contain sharps

·       Contaminated sharps. Any contaminated object that can penetrate the skin—needles, scalpels, broken glass, broken capillary tubes, exposed ends of dental wires, and so on

·       Decontamination. The use of physical or chemical means to remove, inactivate, or destroy bloodborne pathogens on a surface or item to the point where infectious particles can no longer be transmitted and the surface or item is safe for handling, use, or disposal

·       Engineering controls. Controls that isolate or remove the bloodborne pathogen hazard from the workplace (sharps disposal containers, self-sheathing needles)

·       Exposure incident. Eye, mouth, other mucous mem-brane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from an employee's duties

·       Hand washing facilities. The adequate supply of running water, soap, single-use towels, or hot-air drying machines

·       HBV. Hepatitis B virus

·       HIV. Human immunodeficiency virus

·       Occupational exposure. Reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from an employee's duties

·       Other potentially infectious materials (OPIM):

—    Human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids when it is difficult or impossible to differentiate between them

—    Any tissue or organ (other than intact skin) from a human (living or dead)

—    HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; blood, organs, or other tissues from experi-mental animals infected with HIV or HBV

·       Parenteral. Piercing mucous membranes or the skin barrier through needle-sticks, human bites, cuts, abrasions, and so on

·       Personal protective equipment (PPE). The clothing or equipment worn by an employee for protection against a hazard

·       Regulated waste:

—    Liquid or semi-liquid blood or OPIM

—    Contaminated items that would release blood or OPIM in a liquid or semi-liquid state if compressed

—    Items caked with dried blood or OPIM that can release these materials during handling

—    Contaminated sharps; pathological and microbiological wastes containing blood or OPIM

·       Source individual. Any person (living or dead) whose blood or OPIM may be a source of occupational exposure to employees; examples include but are not limited to:

—    Hospital and clinic patients

—    Clients in agencies for the developmentally disabled

—    Trauma victims

—    Clients of drug and alcohol treatment agencies

—    Hospice and nursing center residents

—    Human remains

—    Persons who donate or sell blood or blood components

·       Sterilize. The use of a physical or chemical procedure to destroy all microbes, including spores

·       Work practice controls. Controls that reduce the likelihood

 

EXPOSURE CONTROL PLAN

The agency must have an exposure control plan. It identifies staff at risk for exposure to blood or OPIM. All caregivers are at risk. So are the surgical, central supply, laundry, housekeeping, and laboratory staffs. The plan includes actions to take for an exposure incident.

Staff at risk receive free training. Training occurs upon employment and yearly. Training is also required for new or changed tasks involving exposure to bloodborne pathogens. Training must include:

—    An explanation of the standard and where to get a copy

—    The causes, signs, and symptoms of bloodborne diseases

—    How bloodborne pathogens are spread

—    An explanation of the exposure control plan and where to get a copy

—    How to know which tasks might cause exposure

—    The use and limits of safe work practices, engineering controls, and personal protective equipment

—    Information on the hepatitis B vaccination

—    Who to contact and what to do in an emergency

—    Information on reporting an exposure incident, post-exposure evaluation, and follow-up

—    Information on warning labels and color-coding

EXPOSURE INCIDENTS

An exposure incident is any eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or OPIM. Parenteral means piercing the mucous membranes or the skin barrier. Piercing occurs through needle-sticks, human bites, cuts, and abrasions.

Report exposure incidents at once. Medical evaluation and follow-up are free. This includes required tests. Your blood is tested for HBV and HIV. If you refuse testing, the blood sample is kept for at least 90 days. Testing is done later if you change your mind.

Confidentiality is important. You are told of evaluation results. You also are told of any medical conditions that may need treatment. You receive a written opinion of the medical evaluation within 15 days after its completion.

The source individual is the person whose blood or body fluids are the source of an exposure incident. His or her blood is tested for HIV or HBV. State laws vary about releasing the results. The agency informs you about laws affecting the source's identity and test results.